Ryo R, Adachi M, Sugano W, Yasunaga M, Yoshida A, Jikai J, Saigo K, Yamaguchi N, Akita H, Yokoyama M
Blood Transfusion Service, Kobe University Hospital, Japan.
Cancer. 1991 Feb 15;67(4):960-4. doi: 10.1002/1097-0142(19910215)67:4<960::aid-cncr2820670418>3.0.co;2-v.
A 61-year-old man with Philadelphia chromosome-positive chronic myelogenous leukemia developed megakaryoblastic leukemia. In the blast phase, his blast cells showed undifferentiated megakaryoblastic characteristics with no alpha-granules or demarcation membranes but with detectable platelet peroxidase (PPO) activity and surface glycoprotein (GP) IIb/IIIa. The patient has remained reasonably well for at least 12 months after blastic crisis, and 6-mercaptopurine alone has been effective in controlling leukocytosis and megakaryoblast proliferation. The expression of mRNA for platelet-specific proteins, such as GPIIb and platelet factor 4 (PF4), was studied in the patient's blast cells by the Northern blot analysis. Both GPIIb and PF4 mRNA were detected in the blast cells. Cytoplasmic maturation occurs later than the synthesis of the surface GP during megakaryocyte maturation. Therefore, PF4 mRNA expression should be a marker of mature megakaryoblasts. The PF4 mRNA expression in megakaryoblastic leukemia may indicate that a patient will have long survival and a good response to chemotherapy.
一名61岁的费城染色体阳性慢性粒细胞白血病男性患者发展为巨核母细胞白血病。在急变期,他的原始细胞表现出未分化的巨核母细胞特征,没有α颗粒或分界膜,但具有可检测到的血小板过氧化物酶(PPO)活性和表面糖蛋白(GP)IIb/IIIa。该患者在急变期后至少12个月情况良好,单独使用6-巯基嘌呤有效控制了白细胞增多和巨核母细胞增殖。通过Northern印迹分析研究了患者原始细胞中血小板特异性蛋白如GPIIb和血小板因子4(PF4)的mRNA表达。在原始细胞中检测到了GPIIb和PF4 mRNA。在巨核细胞成熟过程中,细胞质成熟比表面GP的合成更晚发生。因此,PF4 mRNA表达应该是成熟巨核母细胞的一个标志物。巨核母细胞白血病中PF4 mRNA表达可能表明患者将有较长生存期且对化疗反应良好。